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目的:探讨质子泵抑制剂对外科应激性溃疡出血(SUB)和院内获得性肺炎的影响。方法:回顾性分析2011年1-12月市第一人民医院收治的143例围手术期患者的临床资料,按照预防SUB药物的不同分为质子泵抑制剂(PPI)组(P组,106例)和H2受体拮抗剂(H2RA)组(H组,37例),P组按照PPI用药时间是否超过7 d又分为短期用药组和长期用药组,比较SUB发生率、院内获得性肺炎发生率、ICU住院时间和死亡率。结果:H组和P组患者SUB、院内获得性肺炎发生率、ICU住院时间、死亡率分别为13.5%和15.1%、13.5%和29.2%、(162.8±39.7)d和(148.3±21.7)d、21.6%和28.3%,两组比较,差异均无统计学意义(均P>0.05)。P组中长期用药组院内获得性肺炎发生率、ICU住院时间明显高于H组(P<0.05)。结论:使用质子泵抑制剂预防应激性溃疡出血的患者SUB、院内获得性肺炎发生率与使用H2受体拮抗剂者无区别,但使用质子泵抑制剂超过7 d的患者院内获得性肺炎发生率和ICU住院时间高于使用H2受体拮抗剂患者。
Objective: To investigate the effects of proton pump inhibitors on surgical stress ulcer hemorrhage (SUB) and nosocomial pneumonia. Methods: The clinical data of 143 perioperative patients admitted to the First People’s Hospital of Shanghai from January to December in 2011 were retrospectively analyzed. According to the prevention of SUB drugs, the patients were divided into two groups: the proton pump inhibitor (PPI) group (n = 106) ) And H2RA group (H group, 37 cases). The patients in group P were divided into short-term medication group and long-term medication medication group according to whether PPI was over 7 days. The incidence of nosocomial pneumonia was compared between two groups Rates, ICU length of stay and mortality. Results: The incidence of nosocomial pneumonia and hospital stay in hospital patients in group H and group P were 13.5% and 15.1%, 13.5% and 29.2%, respectively (162.8 ± 39.7 and 148.3 ± 21.7 d , 21.6% and 28.3% respectively. There was no significant difference between the two groups (all P> 0.05). The incidence of nosocomial pneumonia and length of ICU stay in group P were higher than those in group H (P <0.05). CONCLUSIONS: SUB, the incidence of nosocomial pneumonia in patients treated with proton pump inhibitors to prevent stress ulcer bleeding, was indistinguishable from those with H2-receptor antagonists, but hospital-acquired pneumonia occurred more than 7 days with proton pump inhibitors Rates and hospital stay were higher in patients with H2 receptor antagonists.